When do you know if it is time to start dialysis with CKD?

Hello @mzacarias11368 and Welcome to Mayo Clinic Connect. You know, some doctors find it hard to tell patients difficult news. But, the doctor may have stopped himself and realized he was being too up-front with the news. Is your doctor a nephrologist (kidney specialist)? What you may want to do is to follow the kidney and bladder support group. The discussion is really for Caretakers. But before you try to apologize, I’m glad you posted! Sometimes I just need to get out of my comfy chair! Here is the link to the Kidney and Bladder Support Group:
https://connect.mayoclinic.org/discussion/stage-3a-kidney-disease/. I’m sure they will be happy to answer all your questions!

Is this a nephrologist MD? Can you get a 2nd opinion?

I hope so. His nephrologist is having him do blood tests once a month now. She called this morning an hour after his labs. His creatinine is now 5.4 and his egfr is 10. I could not hear the conversation, only long silences and then him saying he would wait another month to see what happens. He said that a few times.
Does anyone know what symptoms I should look for that means it is time for an emergency?

@jprust Nausea, vomiting, metallic taste in mouth, can all be signs that there is a crisis. However, not everyone experiences all these symptoms. Last December when I had a crisis, the only indication was nausea. I thought it was my stepson's cooking being too rich for my liking!

A rapid decline in activity or interest in daily life goings-on, shift in focus or desire to engage. I really hope you or his nephrologist can convince him it is time to think about starting dialysis. It has been proven that the higher your eGFR is when you start, the better chances for a steady outcome. I started at 14%.
Ginger

My friend is at 12percent. What happens next?

I would love to find that research. My husband says his research says it doesn’t make a difference.
I want to thank you for your support. I am having a difficult time with this as I feel like he is so stubborn.

@jprust Here is an article from the National Kidney Foundation which has a lot of very useful information. As you can see, they say at about 15% we are severely compromised in getting all the toxins out of our bodies. I know for me, starting dialysis at 14%, it was still a few weeks before I could realize a difference. Our bodies learn to accommodate the declining function of our kidneys, and we don't realize how much we are feeling poorly until we are feeling better. Hope that makes sense!

Face it, getting to the dialysis stage is a big deal, and even now many doctors downplay it. I think those who push for it at higher eGFR levels are those who have a family member/friend and saw it firsthand, or have concrete testimony from patients.

And this excellent article from My Health Alberta [Canada] explains things well, too! Expand their bullet points to read some great information!
https://myhealth.alberta.ca/Health/Pages/conditions.aspx?hwid=abo2705
Ginger

@christinebarnett72 Welcome to Mayo Clinic Connect. If your friend is at 12% kidney function, I hope they are being followed by a nephrologist on a monthly basis? Has there been discussion yet about dialysis, or any dialysis education. There are several options to decide on.

Many time, a person is not aware of how poorly they are feeling when their kidney function starts to fail, if it is due to Chronic Kidney disease. Our bodies are miracle machines, and learn to accommodate our declining function, especially when it is slow. Kidney disease brought on by uncontrolled diabetes or high blood pressure [the two leading causes of CKD] can be helped first by getting those condition under control as much as possible. Having a team effort with diet, exercise, medication if needed, and solid education is all a plus.

Tell us a bit more about your friend's circumstances, so we may be able to give more pointers?
Ginger

He's my ex-husband actually and he I think is in total denial I think his nephrologist isn't offering him anything in fact Robert told me today that his doctor supposed to let him know when it's time to go on dialysis I don't understand it

He has a skin change he has a nose bleeds he's nauseous and vomiting all the time he's very very tired and it just seems like they're doing nothing for him